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ELI Clinical Professionals answer your questions about children with language delay or behaviour issues. Please e-mail your question to eli@eli-ireland.com and we will do our best to answer you. By submitting your question you give ELI the right to post it on the web below.
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I have been told that the waiting list for an assessment is 2 1/2 years. Is this normal?
Unfortunately, given the number of therapists in the HSE, that is all too often a reality. There are many community care areas that have hundreds of children on the waiting list. It is also true that if your child is assessed by the HSE community care therapist and is found to have more than just a language delay you may find yourself moved to another list to wait again for other services such as occupational therapy or psychological assessment.
You do have options, though, such as paying for a private assessment from providers such as the Solas Centre or at one of the Early Language Intervention schools.
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What can I expect at my child's language assessment?
There are different tools for assessment that you might expect to see if you take your child for assessment. These might some or all of the following:
1. Background information (or case history)
2. Formal assessment
3. Informal assessment
4. Speech assessment
5. Language sample
Generally, the clinician will request background information from you regarding the pregnancy (any complications), the birth/delivery, and any significant medical events or history (such as chronic ear infections) beforehand. The clinician will want to know if there is any extended family history of speech and/or language disorders, and what the parent feels is the problem.
The clinician will combine standardized and informal testing to evaluate the child according to his or her age. There are many standardized tests which could be administered. There are times when a child will sit and can be tested at a table top. However there are many young children for whom this time of assessment is not appropriate and so the testing will be done through play and through parental report.
Often you will see the therapist writing down everything your child says. This is called a language sample and it is another tool that the therapist can use to assess your child’s language. It gives information beyond formal testing and can offer information about length of sentences, number of words, variety of sentences, and use of language in a social setting.
Informal testing is usually done during play. The clinician may want to watch the parent-child interaction, or may interact with the child directly to observe "real world" reactions and communication skills.
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What should I do if I suspect that my child has a language delay?
If you suspect that your child has a delay there are several places you can go:
1. to your GP or a pediatrician;
2. to your local public health nurse for a referral to community care speech and language therapy;
3. to the Irish Association of Speech and Language Therapists in Private Practice (IASLTPP) for the name of a speech and language therapist in private practice;
4. To the yellow pages under Speech and Language Therapists.
It is important to discuss any suspected speech or language delay with your GP or child's pediatrician. Your doctor should know general pediatric guidelines for speech and language development. However, doctors often have different opinions about if and when to make a referral to a Speech & Language therapist. Some like to take a "wait and see" approach, while others will make an immediate referral.
An evaluation (if that is all that is done) is always appropriate if a parent suspects a delay. Generally, a parent's instinct is often correct. If your child really has a speech and language delay it will be identified at the evaluation and the early treatment he/she receives will be essential in alleviating any frustration or behaviour difficulties that might arise because of the language delay.
Before a speech and language evaluation is conducted, a hearing screening or test should be conducted to rule out a hearing loss.
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What is a Speech & Language Pathologist?
A Speech & Language Pathologist is a licensed and certified clinician specializing in speech and language disorders. Speech and language pathology is an American term that implies that the therapist has reached the level of master’s qualification in speech and language pathology.
A Speech & Language Pathologist will evaluate, diagnose, and treat a variety of speech & language disorders. With additional training they may also evaluate, diagnose and treat oral-motor and swallowing disorders.
Speech and language therapy is the term that is more commonly used in Ireland. Speech and language therapists may have a masters level qualification from the University of Limerick, or a bachelors degree in clinical speech and language studies from TCD or NUIC. A speech and language therapist can evaluate, diagnose, and treat a variety of speech and language disorders. With additional training they may also evaluate, diagnose and treat oral-motor and swallowing disorders.
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What is a language delay
A language delay is a difficulty understanding language. It can take many different forms. A language delay can include difficulty with any part of language:
1. Semantics: that is, difficulty or delay with understanding the meaning of words or sentences
2. Pragmatics: difficulty using language in social settings including difficulty making friends, talking to peers, acting appropriately, making eye contact, etc.
3. Syntax: Syntax is the grammar of language including things like the verb to be and future and past tense verbs
4. Morphology: a morpheme is the smallest unit of meaning in language. For example putting ing on the end of a verb changes its meaning slightly and is considered to be different in meaning from the verb itself.
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I have been told that the waiting list for an assessment is 2 1/2 years. Is this normal?